Chlamydia

Overview: What is chlamydia?

“Chlamydia” is actually the colloquial term for various types of bacteria from the Chlamydiaceae family. Typically, they need a host cell in order to multiply. In general, chlamydia can cause various diseases. However, the pathogens most frequently infect the urinary tract and genital organs. So when people talk about chlamydia, they usually mean the sexually transmitted sexually transmitted disease. Sometimes the symptoms are only very mild. This is why a chlamydia infection often goes unnoticed. In Switzerland, infection with Chlamydia trachomatis is a notifiable sexually transmitted disease and has become increasingly common in recent years.

Frequency and age

Chlamydia infection is the most frequently diagnosed sexually transmitted disease in Switzerland. In 2016, 11,013 people were newly diagnosed with a chlamydia infection. Young people and young women under the age of 24 are particularly affected. Men are slightly older at the time of diagnosis.

Chlamydia: causes and risk factors

Chlamydiae exist in two different forms: They live inside cells as so-called reticular bodies, which can multiply and draw energy from the host cell to do so. After the reticular bodies have gone through a development cycle, they transform into so-called elementary bodies without their own metabolism. Chlamydia can only cause infections in this form. The elementary corpuscles are either smuggled out of the host cell or automatically released when the cell is destroyed. They can then penetrate neighboring body cells or be transferred to other people.

The causative agent of the sexually transmitted disease is Chlamydia trachomatis (serotype D-K). It enters the human body primarily via the mucous membranes of the urinary and genital organs. The greatest risk factor for a sexually transmitted chlamydia infection is therefore unprotected sexual intercourse. Depending on the type of sexual practice, the pathogens can also penetrate the mucous membranes of the throat and respiratory tract as well as the eyes and anal area. In addition, transmission to the newborn is possible at birth if the mother is infected.

Symptoms: Chlamydia often goes unnoticed

After an infection with chlamydia, it usually takes an average of two to six weeks for the first symptoms to appear. However, women in particular often have no or only very mild symptoms. A chlamydia infection therefore often goes unnoticed.

In general, however, purulent urethritis is a typical first sign. It manifests itself, for example, in heavy, sometimes foul-smelling discharge and problems urinating (burning, itching, pain). They can often also be the cause of intermenstrual bleeding in women.

Newborns infected with chlamydia at birth, on the other hand, develop inflammation of the lungs or conjunctiva.

Chlamydia: Diagnosis by us

In order to diagnose an infection with chlamydia, we must first have a detailed discussion with you. It is therefore important that you describe your symptoms as precisely as possible. We will also ask questions about your sexual habits, such as whether you have had unprotected sex recently or whether you change your sexual partners frequently. After the medical history has been taken, a physical examination is carried out.

Physical examination for chlamydia

In the case of complaints affecting the urinary tract, genitals or anal area, we will look for visible symptoms such as discharge or redness. We will also palpate the neighboring lymph nodes and the abdomen. This allows him to detect swelling, which can indicate inflammation, for example. To identify the cause of the symptoms, we usually also take a swab from the cervix in women and from the urethra in men. A urine sample can also be taken to detect the pathogen. The samples are then sent to the laboratory and analyzed. In Switzerland, an infection with Chlamydia trachomatis is a notifiable disease. It is also important that your sexual partner undergoes an examination and seeks treatment if necessary. This prevents you from infecting each other again and again.

Antibody detection

With the help of a blood test, we can determine whether you have formed antibodies against chlamydia. However, this can lead to false negative results. This is because it takes a few weeks for the immune system to produce antibodies in the case of an acute infection. Even a positive result cannot prove whether the infection is acute or has been present for some time. However, an antibody test can help to narrow down the causes of possible infertility.

Chlamydia: prevention, early detection, prognosis

70 to 95 percent of women and over half of men with a confirmed infection with sexually transmitted chlamydia do not experience any symptoms. Early detection is therefore often difficult. However, it is possible to get tested. This is particularly useful for sexually active young women. There is no official recommendation in Switzerland to regularly test young women under the age of 25 for chlamydia. However, some gynecologists offer the chlamydia test, for example as part of the annual check-up. In addition, testing is often

• before surgery in the urogenital area,
• before an abortion,
• before the insertion of an IUD and
• during pregnancy.

Even if your sexual partner is infected, you should get tested as soon as possible.

Chlamydia is mainly transmitted during unprotected sexual intercourse. Condoms are therefore the best way to prevent infection. It is also best to use these during oral or anal sex.

Course and prognosis

A chlamydia infection can usually be treated well – especially if it is detected as early as possible. It is also important that your sexual partner undergoes an examination and seeks treatment if necessary. This prevents you from infecting each other again and again. Without treatment, there is a possibility that the infection will spread further. In men, for example, the prostate or epididymis become inflamed. In women, purulent inflammation of the cervix, fallopian tubes and ovaries can occur. In the worst case scenario, the fallopian tubes become blocked and the woman concerned becomes infertile. The risk of a fertilized egg not implanting in the uterus but in the fallopian tube or abdominal cavity is also increased by an infection with chlamydia. In addition, infected pregnant women are more likely to suffer a premature birth and can transmit the pathogen to their child at birth.

Reactive arthritis sometimes occurs a few weeks after a chlamydia infection. A typical sign of this is joint inflammation, which is often accompanied by fever. Sometimes the conjunctiva and urethra also become inflamed. If all three symptoms are present at the same time, experts speak of the so-called Reiter’s triad.